Have you ever used substances? If you have, you are the norm. Most people use substances - both licit and illicit - at some point in their lives. And if they don't, they probably love and care about someone who does.
It's useful to remember that every substance provides potential benefits - and has potential harms. We know that substance use carries risks, including the risk of becoming dependent or developing a substance use disorder. Fortunately, substance dependence and substance use disorders (SUDs) can be treated and managed. We have evidence-based medical, behavioral pharmacological, and public health interventions to address them.
Unfortunately, many of the negative consequences we associate with drug use are not so easily addressed. Many of them are the result of the way we think about people who use drugs and the things that we do to punish them.
Many of the health harms we associate with drug use have nothing to do with the substances themselves - but with our responses to their use. As a society, we are the cause of many of the harms. And as a community, we can create helpful solutions.
If you want to improve care for parents, infants, and families affected by drug use and exposure - you will first need to examine your own attitudes and beliefs. Ask yourself: What beliefs have you developed? Are they useful? Are they accurate? Are they helpful? When you ask yourself these questions it becomes easier to understand why we do the things we do and what the consequences of our actions mean.
Ethics Unwrapped: Implicit Bias,
Moral Agent & Subject of Moral Worth,
and Causing Harm
"A moral agent is capable of acting with reference to right and wrong, and has the power to intentionally cause harm to another. A moral subject is anyone that can be harmed... The moral obligation of moral agents is to use their power with care and never intentionally cause unjustified harm."
The Consequences of Stigma
Stigma Leads to Poor Quality Care
Among the populations of people who use drugs, pregnant women face some of the most severe health and social consequences. Pregnant women who use criminalized drugs are routinely subjected to dehumanizing stigma, insufficient access to evidence-based treatment, and ineffective punitive responses.
Inaccurate media reporting and exaggerated beliefs about harms to drug-exposed infants—such as the myth of the “crack baby”—have intensified this stigma. As a result, the rights of pregnant women who use drugs are rarely considered in the development of drug policies, government-funded social programs, or harm reduction interventions.
Despite these inadequacies, women themselves are routinely blamed and demonized for their drug consumption. This publication serves as a guide for those wishing to implement gender-responsive approaches and policies which are tailored for pregnant women who use drugs. In the development of this publication, the reports from women with personal experiences of drug use during pregnancy was considered as important as the peer-reviewed research and exemplary policy approaches cited.
a publication of the Open Society Foundations
My Daughter’s Birth Exposed the Medical Community’s Anti-Drug Stigma
Olivia arrived through an emergency C-section triggered by Carolyn’s preeclampsia, a prenatal condition involving dangerously high blood pressure. Despite that difficult circumstance, the event should have brought nothing but joy—and joy was, and remains, our overwhelming emotion. But in the weeks after Olivia’s birth, Carolyn and I would learn what it feels like to be thrust under the microscope of suspicion around supposed drug exposure. - read the article
Christopher Moraff for Filter
"As a whole, women with substance use disorders do quite well during pregnancy, due in large extent to access to care, insurance coverage and attention from social services," said Mishka Terplan, an obstetrics and gynecology physician at Virginia Commonwealth University School of Medicine. "Where things fall apart is postpartum. We actually abandon women after delivery."
The year after childbirth is the deadliest for addicted women by Christine Vestal, Stateline for the PBS News Hour
Stigma Hurts All of Us
Stigma disconnects us from each other. It tells us to believe that some people are sick, flawed, beyond redemption, and need to be segregated from the community. That they don't deserve to be treated like everyone wants to be treated.
Break the Stigma
What if, instead of seeing labels, we saw people who are struggling and could be there for them so they didn't feel so along?
What if, as a society, we used empowering words and healthy images to help people feel supported?
Maybe then more of us could feel comfortable telling others when we're having a hard time. Maybe more people would get the healthcare they need.
Bridging the Divide White Paper: Pregnant Women and Substance Use: Overview of Research & Policy in the United States a publication of the Jacobs Institute of Women's Health at George Washington University
Changing how we talk about substance use from the Government of Canada
Women who use drugs: Issues, needs, responses, challenges and implications for policy and practice from the European Monitoring Centre for Drugs and Drug Addiction
In telling stories of addiction, the media should stop spreading images of stigma from The Fix, part of a series by PublicSource